Dr. Mariza Snyder | Women’s Midlife Metabolism

• How do shifting estrogen, progesterone, and testosterone levels create the “second puberty” experience for women in their 30s and 40s?
• What early metabolic and hormonal warning signs indicate that perimenopause has already begun, often years before symptoms feel obvious?
• How do stress, trauma, sleep disruption, and postpartum physiology accelerate the perimenopausal transition?
• What labs and biomarkers matter most for predicting cardiometabolic and cognitive risks during perimenopause?
• Why is early, individualized hormone replacement therapy a longevity tool — and what does the evidence really say about safety?

Who is Dr. Mariza Snyder?

Dr. Mariza Snyder is a functional medicine practitioner, author, and leading expert in women’s hormone health, metabolism, and the perimenopausal transition. With over 15 years of clinical experience, she helps high-performing women understand and navigate the shifting levels of estrogen, progesterone, and testosterone, along with the metabolic and brain-related symptoms that often emerge in midlife. Her work combines advanced hormone testing, personalized HRT strategies, and lifestyle-based interventions to restore energy, improve sleep, and build long-term resilience.

She is the host of the top-ranked Energized with Dr. Mariza podcast and the author of several books, including the upcoming Perimenopause Revolution, which provides a comprehensive, science-backed guide for thriving through hormonal change. Dr. Mariza’s teaching is grounded in both clinical expertise and her own lived experience with perimenopause, postpartum physiology, Hashimoto’s thyroiditis, and concussion recovery — giving her a unique, compassionate lens on what women truly need during this transition.

Her mission is to empower women with the knowledge, tools, and confidence to feel like themselves again and to step into the second half of life with clarity, strength, and vitality.

What did Dr. Mariza and Dr. Scott discuss?

00:00 Intro — Understanding “Second Puberty”
01:10 What Perimenopause Really Feels Like
03:20 Why Women Aren’t Prepared for This Transition
05:00 Ovulation, Hormone Rhythms & Early Warning Signs
07:45 Estrogen Fluctuations, Brain Fog & Mood Changes
10:00 High-Achieving Women and the “Falling Off a Cliff” Moment
12:40 PMS Intensification, Estrogen Metabolism & Gut Health
14:30 Sleep Disruption & the Progesterone-GABA Connection
17:50 Postpartum, Stress & Trauma as Perimenopause Accelerators
22:20 Blood Sugar, Cortisol & Modern Metabolic Dysfunction
27:00 Testosterone’s Underrated Role in Women’s Health
33:00 Why Early HRT Supports Longevity & Vitality
47:00 Dr. Mariza’s Top 3 “Smarter Not Harder” Health Principles

Full Transcript:

Dr. Mariza Snyder: [00:00:00] And so then we move into early perimenopause, and this is where again, the ovaries are like, okay, we are, we are on the wind down. Progesterone has been declining at this point. Okay. I would say when women come to me. On average it's 42 43 years old, because that's where they feel like they literally are falling off a cliff.

Hmm. Their brain is shifting. The breasts are swelling. More, more water retention. PMS symptoms. And I would say that again, estrogen is probably still doing well, but she's fluctuating a little bit. But progesterone is definitely on the decline. Right. And so it's a lot of brain related symptoms. And my, my demographic, a lot of high level, high achieving women.

Who have a lot of balls in the air. Mm-hmm. And then all of a sudden it feels like they don't have capacity for all of that, that they were able to hold. So they're like, man, I used to feel steady. I used to feel sharp. I was very productive, I was high functioning. I could do a lot of high level thinking mm-hmm.

In my job. And all of a sudden, I'm fine.[00:01:00] 

Dr. Scott Sherr: All right, ho. Hello. How are you? Marza, how you doing today? 

Dr. Mariza Snyder: Oh, it's so good to see you, Scott. Good. I'm so happy to be having this conversation with you. 

Dr. Scott Sherr: Well, I'm happy to have you on our podcast, being recently on yours and talking all about the cool things at transcriptions. It was really cool to learn about you and your work.

And of course I know you have your book as well, which we can talk about at the end of the podcast. But we're gonna talk about, obviously throughout the podcast, your, your specialty, which is the sort of perimenopausal timeframe. And one of the things that I liked. That was, I was reading about you as I was, you know, researching for the, this particular podcast was this idea, I dunno if you coined this term or if this is somebody else's term of second puberty, and that's very interesting.

So tell me about how that, maybe, how that term came about, if that's your term or how you decided to start using it, and what do you mean by that exactly. 

Dr. Mariza Snyder: Absolutely. And I just wanted to say that your, our [00:02:00] interview on my show is live right now today, so I'm so excited about to go on Instagram. Um, so second puberty, I, I.

Did not coin the to, but I, I mean, a man, it so deeply resonated with me when I heard that because as a girl, I went through puberty and man, was that a very destabilizing time for me. Like I remember all of it, the emotional rollercoaster, the major changes and shifts and figuring out who I was. The one thing I didn't know about that time in my life, and I don't think a lot of us really understood is that for many girls.

Six to eight year transition mm-hmm. For these hormones to come online. And the what kind of defines puberty is as these reproductive hormones are coming online, but that we are regularly cycling and we're about to step into our reproductive years where we will be rhythmically cycling these hormones pretty predictably for the most of us.

Right. Um, for about 35 years. So it's, I call it the ascension. But you know, we always talk about if you have a girl, like, [00:03:00] oh, just wait until she gets puberty. Right. And so then our second puberty is the dissension. And just as destabilizing, uh, for many women as it was when we were ascending into our reproductive years, we are now descending out of our reproductive years.

Mm-hmm. And as those hormones are. Unconsciously uncoupling, so to speak. Um, it can feel like a reckoning. It can feel like a, a kaleidoscope of many different symptoms, but more importantly, it really shifts who we are, how we feel, and. For many of my patients, the thing that I hear kind of the, the through line is that I just don't feel like myself anymore.

Mm-hmm. Like I am, I am going through a major transition and I wasn't prepared. And so that's why I love having this conversation. 'cause I feel like at least we, many of us were prepared for our first. Puberty. Like there was some conversation, you know, and I think more, we're having more of those conversations with our kids Sure.

Than we used to. Mm-hmm. Um, but [00:04:00] I feel like no one was, no one, you know, women, no menopause is coming there. There's that inevitability. But the transition into menopause, there was a lot of brushing off for many, many years. Mm-hmm. Or many, gosh, many, many, many, many centuries, so to speak. Centuries. 

Dr. Scott Sherr: Yeah. Yeah, totally.

Um, and so the second puberty is really this, this, you call it the dissension. The idea that you're kind of like, you're all those hormones and all that, the cycling is kind of going away. Yes. And you're talking about preparation. And I think this is an interesting one because. I know this, and maybe you can kind of go through maybe the timeframe that you're talking about, but when you think about preparation for perimenopause, menopause timeframe, what age range are you typically talking about on average?

And then how would you consider preparing in this case, in sort of in a preemptive sort of way, as opposed to wait, waiting in know, maybe until things are a little bit more further, further along in the process. 

Dr. Mariza Snyder: Absolutely. Well, I wanna first just, just highlight the menstrual cycle for just a second. 

Dr. Scott Sherr: Of 

Dr. Mariza Snyder: course.

And that it is a [00:05:00] superpower. This isn't how I was brought up though. I was brought up that you are, now that you're a woman, you tolerate these periods and this is just how it's gonna be for a very big chunk of your life. So get ready to get on the toleration train. That was very much the vibe. 

Dr. Scott Sherr: Yeah. 

Dr. Mariza Snyder: Yeah.

I didn't know about ovulation. I didn't, even though maybe it was taught for a brief second in, in that, you know, kind of that health class 

Dr. Scott Sherr: kind of, yeah. 

Dr. Mariza Snyder: Health class. Like for moments? 

Dr. Scott Sherr: Yeah. Back in the seventh and eighth grade. Yeah, sure. Yeah. 

Dr. Mariza Snyder: And I would say that we really focused more on male physiology than we did female physiology.

Mm-hmm. I had no idea that ovulation was this ma just magical energetic event and it really. It's the main event, Scott. 

Dr. Scott Sherr: Totally. Of course. You know, we, yeah. It has to be, we don't need have 

Dr. Mariza Snyder: a period. If we don't, we don't ovulate. Right. Right. I mean, that's the concept of contraception, of birth control pills is that we are turning off ovulation and that bleed is a programmed pill bleed.

Right. 

Dr. Scott Sherr: Like, 

Dr. Mariza Snyder: you know, you turn off the main event and so when, when we're going through puberty, or sorry through puberty, [00:06:00] that ovulation is coming online, but when we're going through the second puberty, we are gonna start to have anovulatory cycles, meaning that not every single cycle are we ovulating.

Hmm. And really the whole purpose of these rhythmic hormones, like the estradiol peak on day 11, day 12, which I always joke, everybody loves day 12, us. Everyone. Totally. Yeah. You know why, 

Dr. Scott Sherr: why, why not, right? Yeah, of course. And 

Dr. Mariza Snyder: no, you know, not everyone's loving day 27 True. Or 2026. That's true. Yeah. Yeah. That estradiol peak man.

We feel energized and confident and sensual, and we're connected and everything feels really good because we're, yeah. 

Dr. Scott Sherr: My, I have a colleague that talks about like the skirts might be light slightly, slightly shorter during that, that timeframe. Exactly. Because 

Dr. Mariza Snyder: we're prepping for ovulation. We're just days out from ovulation.

Right. But that estradiol peak is doing so much more for the body. Right. It's suppressing. It has, it's a tumor suppressor. In terms of it's modulating the immune system. It's doing so many other things. So these are full body hormones. These aren't just bikini medicine hormones or reproductive hormones. I mean, they are, they are shifting the body in a profound way.

And your [00:07:00] body is used to that. It's, it wants that estradiol peak, it wants that progesterone peak in the second half of that luteal phase. Sure. And you only get progesterone if you ovulate. And so as we're moving through even kind of late reproductive stage, you know, you hear about a pregnancy after 35, it's a geriatric pregnancy.

I, I had a geriatric pregnancy. Advanced maternal age. Yes. My wife had a couple 

Dr. Scott Sherr: of those. Yep. Mm-hmm. And 

Dr. Mariza Snyder: the reason for that is that we, at that point, we only have so many eggs left. You know, give or take, you know, 15,000 or, you know, by the time we're 40, it's like 10,000 or less. 

Dr. Scott Sherr: Okay. 

Dr. Mariza Snyder: And the body knows that.

The ovaries know that. And so there's this wind down, and again, it's very different. It's very individuals for each and every one of us. But we do know that there's gonna be. The beginning of anovulatory cycles that lead to, well, the lack of production of as, of progesterone in that second half of the cycle, or just not as robust of the production of progesterone.

And so we also know that in this time, women are really [00:08:00] ramping up their careers. So stress is, is very much at play here. And you know, there was a misconception about progesterone being stolen by cortisol, and we know that that isn't true. We know really what it is, is that ovulation is being disrupted by a lot of stress in the system.

Mm. Okay. Whether that's, you know, stress in your life, marital stresses, or life stressors, or even just the stressors. Of, you know, the chemicals in your system, the environment. Yeah. Maybe it's the, the types of foods that you're eating that that is all having an impact on ovulation as well. So I would say that women in late reproductive stage, let's say mid thirties to late thirties, early forties, they may start to notice.

Subtle signs in their cycle. Mm-hmm. Particularly in that luteal phase, they may notice that their recovery in in exercise isn't what it used to be. Hmm. They also may notice that their stress resilience is shifting, maybe their PMS symptoms that they've always had that were just two days, or now three or four days.

Hmm. Again, it's very subtle and it can easily be [00:09:00] brushed off as the daily pain points of everyday life. And so then we move into early perimenopause, and this is where again, the ovaries are like, okay, we are, we are on the wind down. Progesterone has been declining at this point. Okay. I would say when women come to me.

On average it's 42, 43 years old because that's where they feel like they literally are falling off a cliff. Hmm. Their brain is shifting. Um, again, estradiol, it's more, I would find in majority of women we're more in a more estrogenic type of state. Sure. So I wouldn't call estrogen dominance, but they're noticing the breasts are swelling more, more water retention.

PMS symptoms. And I would say that again, estrogen is probably still doing well. Okay. But she's fluctuating a little bit. But progesterone is definitely on the decline. Right? And so it's a lot of brain related symptoms. And my, my demographic, a lot of high level, high achieving women who have a lot of balls in the air.

Mm-hmm. And then all of a sudden it feels like they don't have capacity for all of that, that they were able to hold. So they're like, man, I used to feel steady. I [00:10:00] used to feel sharp, I was very productive, I was high functioning. I could do a lot of high level. Thinking mm-hmm. In my job and all of a sudden I'm finding that it's not as easy to do those things anymore.

Dr. Scott Sherr: Right. 

Dr. Mariza Snyder: So I'm more irritable. Yeah. 

Dr. Scott Sherr: Yeah. So I just from a, maybe just. One thing that you just mentioned that I didn't actually know until now, which I'm obviously um, a little bit embarrassed, was the idea from like an an an when you're not ovulating. So you actually have an an, an anovulatory cycle. Your progesterone peak in the second half of your cycle is not going to happen or it's gonna be significantly decreased.

Okay. That's. Something that I didn't know exactly. So that's good for me to know. Um, just wanna point that out, that, you know, I don't know everything either, of course. About this is really, like, this is very interesting for me. Um, on the estrogen dominant side of things. Yeah. Like you're talking about people, uh, feeling that they're not as sharp, that their, um, that their brain isn't working as well.

Um, would we think that, you know, typically we think of progesterone as more of like your relaxing hormone as the one that kind of like helps you sleep. And, and obviously when going through [00:11:00] perimenopause is very common for women to have a difficult time sleeping, and I've always thought about it more from a progesterone depletion kind of deal.

But, but why do we think that some of that, the brain fog and some of those concentration or, or like their water wheat, why is that happening from an egen dominance perspective, what we say? 

Dr. Mariza Snyder: Absolutely. That's such a great question. Yeah. I think really what we're seeing, you know, I find that there's definitely a Goldilocks scenario here, right?

Where if the body's expecting a high level dose of progesterone in that second half of your cycle mm-hmm. Kind of mid cycle, but she didn't show up, she didn't show up to the table that, that, that week or that month. 

Dr. Scott Sherr: Yeah, sure. And 

Dr. Mariza Snyder: estrogen is kind of still doing what she's doing. Then we, we know that, you know, if we're not able to process it quickly, especially if the liver and the gut aren't doing their job, if someone is more chronically constipated as well mm-hmm.

They're not having regular bowel movements every single day, then that kind of spillover of estrogen we, we know is gonna drive kind of more of a pear shaped. So we see more, more weight on the hips and butts and thighs. We see more. Fibrocystic [00:12:00] breasts, we even see fibroids developing as well. And so like 88% of women by the time they're in menopause, will have developed fibroids.

Maybe not all of all of them notice, but we know that this erratic shift in estradiol, particularly in this transition, is going to lend to at times more estrogen. Than, than progesterone. And then at at one point, at some point, progesterone just stopped showing up. 

Dr. Scott Sherr: Right, exactly. Yeah. So 

Dr. Mariza Snyder: then we just have erratic estrogen levels, so, so I would say that that that's one, be that presentation of too much estrogen in the system that we're not able to clear plus excess estrogen metabolites.

Makes sense. Lends to the bloating, potentially migraines, the fibrocystic breast, little bit of weight gain. And then. If we don't have, you know, GABA showing up and progesterone showing up, we're gonna notice those, those symptoms heading into, um, the beginning of our cycle to menstruation are going to be more, again, kind of tho that rage, that irritability, that low stress tolerance.

Sure. That we really were able to taper because we had, because progesterone showed up [00:13:00] that much. 

Dr. Scott Sherr: Right. Makes a lot of sense. So like it's a balance and it's also the cycling of that balance between one or the other. And then I think that the other aspect of this is just the, the ups and downs that happen as a result of the anovulation, for example, or the, the lack of as much progesterone.

And then, you know, of course, as you mentioned with progesterone, it's very important for sleep because it enhances the GABA system as well. 

Dr. Mariza Snyder: Yeah. A, a real recent research, not that we didn't know this, it's clear if you're seeing women in midlife in your practice, they're not sleeping. And period. Hard stop.

Like that is always my wife. My wife 

Dr. Scott Sherr: is, but you know, she's, she's the exception to the role that I have to lose. Okay. Okay. She's got, she's got great genes. Like, you know, she could sleep through, like I love that she can through, through like fire trucks and crazy. That's amazing. I know. Yeah. And I'm 

Dr. Mariza Snyder: sure that there were gears for your wife when, you know, when she was having children that just by default, right.

Um, that, that there was a lack of sleep there. You know, of course, you know, one of the risk factors for Cardiometabolic health are issues for women. The root causes is that women consistently have less quality sleep throughout their lifetime. 

Dr. Scott Sherr: Hmm. Yeah. Whether it's 

Dr. Mariza Snyder: due to cycling hormones or [00:14:00] it's due to perimenopause, menopause, or children, but most importantly, caregiver burden.

Dr. Scott Sherr: Yes, exactly. Lots of like, I think in my house it was about 10 years of that. Yeah. So, yeah, so 

Dr. Mariza Snyder: there's that. And I, you know, I just, I just got home and I slept with my son last night. We both co-sleep, but, um, I, my son, my son mostly sleeps with my husband because sleep will make or break me. It'll make or break me.

Yeah. You know, it can feel like if I don't get the, uh, the quality of sleep, the deep quality sleep, or I have the sleep consistency that my brain relies on, it can feel like I had had three glasses of champagne Yeah. The night before. Yeah. And I haven't touched alcohol in years. Right. I, that's what it feels mean.

I have mom guilt 'cause I'm traveling a lot and my, they just left. My son and husband just left and so I promised my son that I would sleep with him all night last night. 

Dr. Scott Sherr: How'd that go? And I knew how'd that go? Did not 

Dr. Mariza Snyder: go great for me. He loved it, but it's, it's the sacrifice. So I woke up today and I was like, oh yeah, this is exactly what I thought I was.

And I even went to bed extra early knowing Sure. That there were gonna be many sleep disruptions Sure. [00:15:00] Throughout the night. Sure. Just 'cause his, his hand hit my face. Of course, you know, he ended up kicking me, you know, it's all these things. He sleeps on me. His, he, I, one part of my night is, his head was on my head.

Oh 

Dr. Scott Sherr: my goodness Know, he's, I cant do that. I can't do it. I can't, I I mean, you've heard of the sleep divorce, right, Marissa? So, 

Dr. Mariza Snyder: oh, yeah. I'm, I'm sleep divorced. 

Dr. Scott Sherr: Oh, you do? So you and your husband sleep in different rooms? Yeah, 

Dr. Mariza Snyder: we sleep in different rooms. 

Dr. Scott Sherr: Nice. Yeah, that's actually, and we've been 

Dr. Mariza Snyder: divorced for two years.

Dr. Scott Sherr: Yeah. There's a better word for it. Now that doesn't sound like diverse divorce, like sleep union or sleep agreement or something like that. Have you heard this? Trying to make it sound more positive? I 

Dr. Mariza Snyder: have. I'm still calling it a sleep divorce. Okay. But I'm, and I, and deeply grateful that my husband's.

Co-sleep with my son and it's not me. Got it. Got it. Um, Alex is able to, he's more resilient. He's, he's younger than me. He's, he has more capacity than I do, you know? Nice. And so good for you. We can really do it. Um, but I do make these beautiful exceptions. I mean, my son, if he can, he always wants to sleep with mama.

Yeah, 

Dr. Scott Sherr: the sleep divorce thing is a big one. I mean, and from like a, a diet lifestyle behavior side, like, like the sleep part is so big for all of us. Um, [00:16:00] did you notice, when did you decide to do that yourself? Was it something that you've done for most of your relationship or was it something you guys decided later on?

Dr. Mariza Snyder: No, when I was 43 years old, my son was two and a half. Um, I was still breastfeeding, but I started experiencing perimenopause and then I got two major concussions back to back within two 

Dr. Scott Sherr: weeks. Oh goodness. Okay. And 

Dr. Mariza Snyder: I basically. Spiraled. It was about two summers ago. I'm literally, I, at this time, two years ago, I was in a dark room praying to God that I was gonna recover.

Dr. Scott Sherr: Oh my goodness. Yeah. Yeah. And so, um, 

Dr. Mariza Snyder: at that time, um, we decided I had to, I had to stop breastfeeding because I had to get on progesterone and high levels of glutathione. And there was just a lot of supplements and support that I needed to heal my brain. And it wasn't conducive to me, um, sleeping with my or breastfeeding my son anymore.

Totally understand. So we excited. Because the sleep was so mission critical for my healing that my son, my husband, would take over co-sleeping with my son. 

Dr. Scott Sherr: Hmm. 

Dr. Mariza Snyder: And it took me, I was in the trenches, I would say, kind of in the dark hole of that healing journey for at least three months. Mm-hmm. Where I was in brain [00:17:00] recovery treatments.

Sure. Hyperbaric oxygen, um, almost every single day. Right. Um, there were days where I couldn't, I couldn't, but the first month I wasn't able to drive my car, um, or first couple weeks not to get ready. I couldn't get my son ready. It was a very, it was a very challenging time for all of us as a family, but my husband really stepped up and he's the one who took over co-sleeping with my son.

And so we have basically have maintained that ever since because even though my brain is sharper and more clear. In the midst of perimenopause. Oh my goodness. Then it had, you know, it had even been a year ago. Um, I know that if I was consistently sleep, um, sleep sleepy with my son, um, I would definitely have a little bit of a spiral out again.

Dr. Scott Sherr: Yeah. Well, thank you for sharing that. Um, Marissa, that sounds like it was quite. The ordeal, uh, with the concussions and, and everything. And obviously I have a lot of experience on that side of things involved in hyperbaric medicine for a long time and a lot of concussion recovery. One of the things that I did actually just recently learn from a colleague of mine is that a significant event like that can have a massive [00:18:00] effect on perimenopausal, uh, hormones and either sort of the rapidity or like how fast things might change.

Was that your experience or was it something that, you know, you'd already noticed it was ongoing before you had the concussions? 

Dr. Mariza Snyder: Yeah. You know, if we really wanna rewind a little bit because I think about how many women are having children later. 

Dr. Scott Sherr: Yeah, totally. 

Dr. Mariza Snyder: And then they kind of, there's no gap between postpartum and perimenopause.

Um, it wasn't until my son was two that my cycle even came back. Mm-hmm. So for two years I didn't have, have a cycle. 

Dr. Scott Sherr: Wow. 

Dr. Mariza Snyder: And so I was kind of just living in this postpartum, whatever, you know, I would say Forex. Um, and particularly probably 'cause I decided to breastfeed my son for so long Sure that hormones weren't coming back online.

So they had just been online for four months before I started to notice. Again, subtle symptoms. I wasn't clear. I remember when I started feeling fatigue and brain fog. This was about two months prior to the concussions. Um, and I remember. Like, again, not feeling like myself, like something, something's not right [00:19:00] and I, I will tell you that I did not come into pregnancy or perimenopause with a clean bill of health.

I had been diagnosed with Hashimoto's thyroiditis before that I had burned myself to the ground many times Before that, I had at one point probably had insulin resistance. Just didn't know. Sure. And, um, and so when I started having these subtle symptoms, I thought it's gotta be a Hashimoto's flare, or my thyroid isn't dialed something, something isn't right.

Mm-hmm. I remember going down the rabbit hole, take, doing all the tests, you know, again, we, we kind of just don't wanna admit it's perimenopause until it's so obviously, oh my gosh, this is what I'm going through. Right? Um, but in this discovery of trying to figure out what was going on with my body and my brain and everything, I got hit in the head twice.

And so that became its own. Journey. Um, and it wasn't until I was on the other side of that, that fall winter where I had rage three months in a row that I knew. And I thought initially the first month of rage, I was like, oh, maybe this is still delayed. Concussion [00:20:00] syndrome, um, symptoms. Sure, sure. 'cause people will have major mood changes and rage, um, after concussions, of course.

So I thought, oh 

Dr. Scott Sherr: yeah. 

Dr. Mariza Snyder: This is a concussion symptom. I'm having rage. Um, my mom also had rage in perimenopause. That was her, her truest biggest symptom. 

Dr. Scott Sherr: Wow. Okay. Um, 

Dr. Mariza Snyder: but I started, I started tracking my cycle against my, around my symptoms. I always, always recommend women track your cycle. It's your monthly report card also match your symptoms.

Two year cycle because the beginning of perimenopause, these symptoms are often cyclical. 

Dr. Scott Sherr: Mm. 

Dr. Mariza Snyder: Right. They, so literally seven days before my period, three months in a row, I would wake up with this deep sense of dread, like life was insurmountable. Wow. Five days ago. It wasn't, I was able to, I was handling everything just fine, and I would wake up with this and then this, this rage that I just felt like was uncontrollable, that it just wasn't who I was.

And I started to track, and it was that third month, it was November of 23. I was like, this is perimenopause. This isn't just a concussion. 

Dr. Scott Sherr: Hmm. Wow. So that's 

Dr. Mariza Snyder: how I knew. Yeah. But so often women, it's a [00:21:00] unique experience. Right. There were so many things that were happening to me at the same time that this was presenting that made it really murky for me to know that, oh, it's a yes and.

Dr. Scott Sherr: Yeah, totally. I mean, you got a pretty significant sort of transition there, right? Because you have the concussions at the same time, but I, I think you, you make a really good point that so many women are having babies later. So that transition could be very quickly from one to the other, from being postpartum to breastfeeding, then all of a sudden being perimenopause.

And then of course, as you said, women are very active at this point in their life, in their late thirties and forties. And this is where they may have multiple kids, they have, may have multiple jobs. Um, but yeah, I was in just interested on the side of. The concussion or like a surgery for example, or a severe trauma of some sort?

A sort a trauma, yeah. Yeah. Where you could have like a significant sort of cliff dive of some of those hormones as a result of that. 

Dr. Mariza Snyder: Absolutely. Yeah. One of my dear friends, Dr. Jessica Drummond had long COVID, I don't know if you know her. No. Um, she works a lot of women with endometriosis, but her specialty is looking at.

Women in [00:22:00] perimenopause, but also with chronic illness, chronic infections, and how it was actually her long COVID COVID that shoved her from very early, early peri straight into menopause. Got it. And so that is where, that's kind of a niche that she focuses on, is women who have a pretty severe trauma.

Mm-hmm. Or a severe, like a viral infection that just. Sends them from Perry right into menopause. And so we, we do know that these types of stressful events or traumatic events can have a profound impact on our, our rhythmically. Our, our rhythmic hormones, our menstrual cycle, and can kind of push up the timeline into menopause a little bit sooner.

Dr. Scott Sherr: Yeah. And this is, this makes a lot of sense to me because, you know, when you have a traumatic event, um, also causes significant profound inflammation in the system. It causes immune dysregulation. It's gonna gonna cause hormone dysregulation. If you're already kind of on that, that edge, you know, and then all of a sudden you have one of those kind of insults [00:23:00] and things can kind of go haywire and.

Be difficult to come back to where you Before. Before for sure. 

Dr. Mariza Snyder: Yeah. And even just the minor insult of stress, everyday stress in that we, you know, up until a point, I think, you know, I, I used to think at stress and, and revving my stress response system mm-hmm. When I was younger was my slight edge. Sure. I was like, Ooh, I, I'm gonna just turn this system on and I'm gonna, I'm just gonna bypass you.

And you know, in your twenties you can kind of get away with it. It's okay. You can Absolutely. Yeah. Even in your 

Dr. Scott Sherr: thirties maybe. Yeah. Even, yeah. Into your early thirties. Yeah. 

Dr. Mariza Snyder: 35. My body was like, hard stop woman. You can't do this anymore. Yeah, 

Dr. Scott Sherr: yeah. No, I get it. Mine was 40. When I turned 40. It was like, okay, you can't do it anymore.

Yeah, I get it. Yeah. 

Dr. Mariza Snyder: I mean, even in high school, I was racing. Like, my life depended upon it. I, I grew up with a lot of child abuse. I grew up with just surviving. Got it. And no one betting on me. So even, you know, you had that little five minute break between classes. I was meeting the principal deciding, you know, what, what the big agenda for spirit Week was.

You know, this was, this was my life. Gotcha. And so [00:24:00] even in high school, I was racing. I was, I was running from myself. Maybe I was running from my trauma, I was running from the abuse I was dealing with. Sure. I was trying to escape. And so I think from an early age, I kind of was burning the candle at both ends.

Um, so it caught up to me a little bit earlier. I remember. Being in practice with so many women in their forties and fifties and midlife. And I had the exact same symptoms that they did. 

Dr. Scott Sherr: Hmm. 

Dr. Mariza Snyder: And I thought, oh goodness. Like I'm, it's 15 years, 20 years away from now, I better, I better figure this out. But as we head into Perry in particular, you know, you, again, you've got all these balls in the air and you're, you were able to do it.

Yeah. Kinda like you said, 40. And then hormones begin to shift this, this shield I call, they're these protector hormones. They begin to erratically shift. Sure. And all of a sudden. Things that you were able to keep under control, that you were like, I got this, I, I can handle this stress or this insulin resistance, or a little bit of this metabolic dysfunction that's happening, or, or my thyroid, I can, I can keep her at bay, uh, all of a sudden with, you know.

Symptoms that you may not have known [00:25:00] about. Right. Become, become more apparent. They present more and things that you had under control become to come up for review again. So I think a lot of women were like, man, I had this under control, and now it's all falling apart. 

Dr. Scott Sherr: Wow. Yeah. And you've talked about this, I know, a, a number of the things that you've done as far as the, the metabolic side, and you mentioned having, you know, some hashimoto, some other things going on before you went into the perimenopausal state.

How do you think about. Metabolic health for women now. I mean, and, and as opposed to men, right? So like, obviously, you know, men and women are not the same gender. We have a lot of things that are different and we're not the same. And, and unfortunately, and I did a podcast with the lady a long time ago. Her name is, um, Kayla Osterhaus.

And she does all this research on how, you know, most of the research obviously has not been done on women over the years. No, no. And she's trying to change that. And she has a really cool thing that she's been doing. Um, but. How do you think about metabolic health for women? What do you, what are the main things that you're looking at?

What are you trying to like? Again, I'm, I'm thinking more like the preemptive side here, right? So like people's kind of going through, like say you're like late thirties or like mid thirties and you're like, okay, I really want to [00:26:00] sort of optimize and like what, how is your approach, what is your approach for women in that capacity?

Dr. Mariza Snyder: Absolutely. Well, I think, you know, just centering back to the menstrual cycle in ovulation as well. I think if there was a. I don't know if there's a more energetic event that requires good metabolic health than ovulation. 

Dr. Scott Sherr: Yeah, for sure. You know, for sure. I think the 

Dr. Mariza Snyder: big distinction between you and me is that I 3D print people, you know, that's, it's kind 

Dr. Scott Sherr: of a big distinction, like, let's be honest, right?

It's a huge distinction. I don't understand how 

Dr. Mariza Snyder: we Yeah, 

Dr. Scott Sherr: yeah. It's not a, it's not a small one. Yeah. Ovaries have the most mitochondria per cell too, right? You guys? Yeah, exactly. Massively amount of massively. Yeah, 

Dr. Mariza Snyder: and especially right before, right at ovulation as well, right? When then, and then if we get pregnant, then that really, that amps up in a really big way.

I always say that pregnancy is a it. It's the biggest marathon you'll ever run. You know, the amount of energy that's required, the amount of thyroid hormone that is required just to make that work is just. Incredible. 

Dr. Scott Sherr: Yeah. I think there's some relationship to like the thyroid hormone drop with some morning sickness, sickness symptoms too, if I'm not mistaken.

Right? 

Dr. Mariza Snyder: Absolutely. So for me, with Hodges, I, we ended up [00:27:00] increasing my dosage well before, even before, like right when we knew I was pregnant. Mm-hmm. We, we increased that, that dosage to ensure that I had enough thyroid hormone. To maintain the pregnancy and, and maintain a very, very healthy pregnancy. So all of those things are taken into account even during pregnancy.

Right. But I think about, you know, all these women that I, I've taken care of over the years with polycystic ovarian syndrome. Mm-hmm. And then we see that developing even in our teens. The, the NHANES study just got updated where one in three children, um, are pre-diabetic. Um, currently Wow. And one of four children have full-blown diabetes.

Dr. Scott Sherr: It's crazy. 

Dr. Mariza Snyder: I just wanna just sit with that for a second. 'cause that is just mind blowing. 

Dr. Scott Sherr: It is mind blowing. Yeah. 

Dr. Mariza Snyder: And then we think about these girls who have some level of metabolic dysfunction heading into, you know, into puberty, um, or in puberty and then into our twenties. Are we surprised that we're seeing a ra, uh, one in five women with polycystic ovarian syndrome?

At the root of that, that is insulin resistance, and then that's, if there's a diagnosis, everything's a sliding scale. So there's [00:28:00] gray area where someone can have insulin resistance and have relatively irregular periods, but don't have all the distinct distinctions of polycystic ovarian syndrome. Mm-hmm.

And so I think I get a lot of women who are coming into the perimenopausal transition already having a level of insulin resistance. Okay. 

Dr. Scott Sherr: That's the biggest, right? So big insulin, I would say the biggest root cause. 

Dr. Mariza Snyder: Right. So that's what I'm always looking at. One is I am looking at your cycle. I'm looking to see, you know, I'm looking at your, your labs in terms of your glucose metabolism and your overall metabolism.

Um, and so I'm, I'm taking all those things into account when I am building a protocol for my, for the woman that I'm working with. Um, because, you know, for example, I, I have a patient of mine who's one of my best friends who just happens to come to me. I've known she has two, two boys under five. She's 36 years old.

Um, and she has been run down. She's been trying the conventional approach. She finally came to me and she's like, Marisa, I just, nothing's working. I'm, I'm burned out. And so I had a full comprehensive panel mm-hmm. That I had her take to her, her [00:29:00] naturopathic doctor. And I was like, demand this. I need, I need, I need this information to know what's going on.

Um, her lipoprotein little A is one 50 milligram per deciliter. Um, she was 1 0 1 0 5 milligram per deciliter with fasting glucose, so she's pre-diabetic. Her triglycerides were 150 milligrams per deciliter. So she had, her blood pressure is one 30 over 80. She's me, she has metabolic syndrome and she's only 35, 36 years old.

And so I think about what it's gonna look like for her, knowing how she feels right now, stepping into what I consider to be the zone of hormone chaos. You know, and how do we future proof her to even manage perimenopause with grace and vitality? Mm. That's just gonna be a lot of work. But it's a comprehensive look at, at what that woman's going through.

And then how do I set the, how do I mean, it's a massive lifestyle shift that we're gonna have to be implementing for her. Yeah. To step into perimenopause. 

Dr. Scott Sherr: Right. Right. Um. One thing you mentioned earlier and just speaking there was around blood sugar and insulin resistance. And I was talking to [00:30:00] another friend, her name's Christine, me, and she's a family doc here in Colorado and she was talking to me about how I, there's kind of two elements here.

You like, you like Christine, she's great. Yeah, yeah, she's great. She's my neighbor. She's a 

Dr. Mariza Snyder: very menopause, 

Dr. Scott Sherr: yeah. She talks about it all the time and, and uh, yeah, she's actually writing a book on perimenopause and the gut actually in gut health, which is really interesting. Yeah, I'm super excited about that.

What we were talking about was, and it's interesting, your take as, I didn't know about this and that's why I'm kind of re. Yeah, bringing it up here is the, as is the idea of some, some women have elevated cortisol, not because of insulin resistance per se, but because of stress, because of just chronic stress and, and making the, the distinction can be very, very powerful in how you kind of address, you know, what you call the, maybe the root causes, right.

Dr. Mariza Snyder: Yeah, I mean, well also just to acknowledge that the co-elevation of cortisol is going to drive insulin resistance. 

Dr. Scott Sherr: Exactly. Yeah. 

Dr. Mariza Snyder: Cortisol is a survival hormone. Right. And, and thank goodness for it to be able to modulate our immune system and to wake us up in the morning and to be essential part of circadian rhythm, um, function.

I, I don't know if everyone's got optimized circadian rhythm function, but Sure. Yeah. [00:31:00] Cortisol is a part of that conversation. Um, but what I, you know, this is why, how I knew in hindsight I had insulin resistance. I always blamed it on cortisol, but I was addicted to sugar. Like, ah, and so it, it was a tailspin, it was easy to pin it on the stress.

Dr. Scott Sherr: I see. Gotcha. But 

Dr. Mariza Snyder: I was, I was constantly feeding a stressed system. Sure. And as a result, I was, I mean, I would say that I was on a perpetual blood sugar rollercoaster for probably a decade. 

Dr. Scott Sherr: I'd 

Dr. Mariza Snyder: had no idea. I was just trying to survive on trying to fuel energy. Right. You know, just the wrong kind. Yeah. And so, yeah, I mean, I think a lot of women come into peri one, some level of insulin resistance if only 7% of us are metabolically healthy.

Yes. Like, let's do the math. How many of us are coming into perimenopause? Metabolically alive? Um, and then you, you add in the disruption of these hormones and, and really having to rely on more survival hormones like cortisol. Often that's deregulated. And so it really is, you know, I, I don't believe any [00:32:00] hormone is operating in a silo, of 

Dr. Scott Sherr: course.

Absolutely not. And 

Dr. Mariza Snyder: so I find that it's a lot of these hormones that are deregulating all at the same time. So it's not just estrogen, it's not just progesterone. Yes, that could feel like finally, that was the straw that broke the camel's back, but most likely you've had some level of insulin resistance and cortisol's been a bit deregulated.

But now that you don't have these protective hormones keeping everything in somewhat of a homeostatic state, it just all feels like it blows up in your face. 

Dr. Scott Sherr: I love the, the, the way you describe 'em as protector hormones and what you're obviously speaking about estrogen and progesterone. And progesterone.

However, there's also this other one called testosterone. Yes, there is the most 

Dr. Mariza Snyder: biologically active hormone in a woman's body. 

Dr. Scott Sherr: Yeah. So please describe that a little bit. 'cause I think it's important that women understand this and, and also clinicians that are working with women in the perimenopausal timeframe, like testosterone levels are also important to be understanding and like what the, what the role of testosterone is overall.

So maybe you can go into that a little bit. That'd be great. 

Dr. Mariza Snyder: Yeah. I absolutely think, I think about testosterone as a [00:33:00] beautiful, not only a growth hormone, but a confidence and, um, and like, just it's, it's one of those hormones that is gonna help you feel more vital in general. Mm-hmm. So we think about when it's at its peak for both men and women.

Right. It's in our mid, mid to late twenties, depending on the person. Yep. It's going to decline. There's no, there's no way around it that we're gonna start to see that decline. By the time women are in menopause, we have 50% of the testosterone that we had at our peak. Mm-hmm. And for some women that can be much sooner than others.

So what we'll notice with testosterone one, I mean, the only one we don't have an FDA a approved testosterone for women with currently. 

Dr. Scott Sherr: I'm aware. It's crazy. Yeah. Yeah. It's so crazy. Yeah. We 

Dr. Mariza Snyder: have a, uh, buffet of options for men, but not for women. And, and what we'll notice when women are. Struggling with testosterone.

So low libido is a, a big player here. Of course. Yeah. And that's really the only thing that we technically re you know, is recognized or is, is appropriate, clinically appropriate [00:34:00] to actually prescribe testosterone for women. Mm-hmm. Is that you, have you really significant low libido or it, it just, it stops showing up to the, to the, the conversation completely.

Mm-hmm. Um, but we know that off label. Testosterone is phenomenal for confidence and motivation and brain function and muscle recovery and muscle protein synthesis. And also when testosterone is working really well, we do have a great, we do have greater metabolic health. Yes, we do. We, yes. And so that is a big player as well that I'm always looking at.

Um, and so it's something that we, I think that. As a clinician, we always need to be looking at, we always need to be testing hormones. We always need to be looking at testosterone, running a full testosterone panel so that we have a sense, is that something that someone is needing? I am, I'm I, full disclosure, I'm on all the hormones.

All I, I take thyroid hormone. I'm on progesterone. I've got my progesterone patch on, or sorry, my estradiol patch on right now. I am a cycle progesterone, so Sure. I'm in the luteal phase of my cycle, so I took it last night and um, I use testosterone cream [00:35:00] every single day, so there's that. Okay. 

Dr. Scott Sherr: Well, I love it.

And, and so you're talking about testing, and maybe we'll talk about that for a little bit here. Right? So there are some arguments that testing in perimenopause isn't helpful and you should just work with patients and do hormone management depending on their symptoms. There's others that believe that certain hormones can be helped be tested.

I know that, for example, testosterones relatively, uh, stable decline as, as far as like measuring estrogen and progesterone kinda all over the place. So what's your, what's your take on this? 

Dr. Mariza Snyder: Always look at the numbers. Always look at the numbers. Why not? Yeah. And, and yes. If, if a So with nuance, of course.

Yeah. So if I have a, a friend of mine who can't get the full testing, you know, just, just as a bestie, as a friend, as a woman who cares and they are, they, it's very clear that they are struggling with hormones. They have very significant symptoms of test one, always test testosterone, but let's say it's estrogen, progesterone, yeah.

Everything. Yeah. Like, it's very clear all of them. You've got sleep issues and it's very clear. And you, you've got a provider who won't test, but who will prescribe. Take the prescriptions [00:36:00] Right. And, and, and then, and, and figure it out based on symptoms. That's really how we operate in, in very, you know, at a very conventional medicine standpoint mm-hmm.

Is that you go to your provider and they won't test your hormones, but based on symptoms they will prescribe. Right. And I am, I'm okay with that, if that means that you're getting support, but that is not what I do. 

Dr. Scott Sherr: Okay. 

Dr. Mariza Snyder: You know, I wanna see, I wanna see everything. I, I call it reading the tea leagues. I want, I wanna know your symptoms.

I wanna know your history. I wanna know what's going on with you right now. What's in your life. I wanna, I want a full panel. I want everything. I want. Look, I wanna look at all the kind of advanced cardiovascular. Um, labs. I wanna look at the full cardiometabolic scenario. Mm-hmm. I wanna look at a full thyroid panel.

Full iron and ferritin panel. Got it. I want got everything. I want all the hormones. Okay. I just wanna see everything. I wanna look and see how everything is working with each other. Ideally, I want a diurnal, you know, saliva, cortisol curve. I want the full 24 hours. If I can only get the AM cortisol, I'll take it.[00:37:00] 

But I just, that really allows for me. And your goals. What are your goals? What, what are you really trying to achieve? What would you love to feel in the next 30 to 90 days? That's how I like, mm-hmm. To take care of a patient. And that's how I build protocols, is all of that information I take into account.

And then build a protocol that will work with you. And what I mean by working with you is, let's say I do want you strength training four days a week, and I want you clocking 10 to 12,000 steps a day. Mm-hmm. But let's say that that is not a possibility. Some of that isn't. Mm-hmm. And so I'll take two days a week.

Like I if, if, if my protocol is so outrageous as, or too strict or whatever that may be, that it's not even possible for you in the life that you're living right now. Well, that, that's not a protocol that's ever gonna work. And so I wanna make sure that I'm meeting you where you at stretch you to the point that we're gonna see positive change 

Dr. Scott Sherr: mm-hmm.

Dr. Mariza Snyder: But also that it's, it's manageable. Gotcha. Like, it's not going to break you because I've, I've created this crazy protocol for you to implement. 

Dr. Scott Sherr: I love that. Uh, a question for you on reversing ovarian age, any interest in [00:38:00] this aspect of looking at things like AMAs and trying to follow 'em overti over time and interest in how we could potentially extend the time that ovarian, the ovaries are working?

Dr. Mariza Snyder: I 

mean, I'm deeply interested 

Yeah. Right. In reproductive 

longevity. Absolutely. Yeah. Um, and I will tell you that my women aren't. Per se, you know that Sure. They don't necessarily know that that is a possibility. Sure. Um, and I think we're still very much in the infancy stages of like, how do we increase our mitochondrial capacity?

Right. Because that's really what I think at the epicenter of what it is. Mm-hmm. It's mitochondrial function. Um, and so that is a conversation around longevity and so there are supplementations and. You know, ribo, mycin and different things that you can do to help, but I've only really seen the research maybe extend us out for about a year or so right now.

I, I still think we got a long ways to go before we really fully understand how to preserve our ovaries, um, so that we are living longer and well, not even just living longer, living a higher quality life. Because the, [00:39:00] it's just important for everyone to know that although women live longer, right? Our, our, our average age expectancy as a woman is, is 81 years old.

And for men it is 76, and although we are living longer than you, 25% of our lives are spent more in debilitating health than men. Right. So if there's anything I can do to help, um, pull, push that back as far as possible, I'm, I'm deeply interested. Right. But I'm not running, I'm not really running a lot of those labs, unfortunately.

I'm still focused more on kind of what we can do like right now with what you're going through. Because I, I think once someone, once they're in the deep. The deep, the whole of perimenopause, I, I haven't been able to really figure out. How to buy them, you know, four more years. 

Dr. Scott Sherr: Totally. And it's a very new science.

And the reason why I ask is I know you're kind of on the cutting edge of understanding. I have some friends as well that are like very focused on how can we extend ovarian age or extend ovarian lifespan, you know, longer so that. You're not having to take exogenous hormones, you're taking the hormones at your body is Yeah.

You're actually 

Dr. Mariza Snyder: just using them. Yeah. [00:40:00] But in, in the meantime, in between time, I think hormones are the most powerful. Yeah. Longevity optimizers that we have at our disposal. 

Dr. Scott Sherr: Yeah. Let's talk about that briefly, uh, in the sense of, you're obviously a fan of, of HRT. You're taking yourself, obviously, and I, and it sounds like.

You have a lot of people in your community that are very all, all over it. But I know that overall, I mean, there's a very few women that are actually on HRT that would qualify as I understand it, right? 

Dr. Mariza Snyder: Yeah. Although we can't fully measure it 'cause so many women are on compounded HRT here in the country.

Okay. But it, it lands between five and 6%. 

Dr. Scott Sherr: Yeah. Of all of all potentially qualifying women. Right. And before 

Dr. Mariza Snyder: the Women's Health Initiative, it was 40%. 

Dr. Scott Sherr: Right. It was much higher then, unfortunately, with all that, and the suggestion that you have, and what I've seen in the literature is that getting on HRT as soon as possible Yes.

Is better compared to waiting. Correct. Maybe talk, talk, talk about why that would be the case. 

Dr. Mariza Snyder: Absolutely. I mean, again, when we're talking about reproductive longevity. Why would we wait until we've bottom out right [00:41:00] with our hormones to then start resupplying our receptor sites with these hormones? It it, it makes the same sense of, I would never, if a patient has Hashimoto's or low thyroid function, I wouldn't be like, you know what, let's just wait until that TSH is like a seven.

Yeah. Or a five. Totally. Yeah. You know, and then, you know, come, come talk to me. Like, we'll run labs in 90 days or in six months and let's see, but she, her hair's falling out. Her, she, half her eyebrows are gone. Her feet and hands are cold. She's constipated, she's brain fog. But I'm like, you know what, let me see how high we can get that TSA before I start to recommend.

Dr. Scott Sherr: Yeah. I'm totally there. I, I'm with you there. But I think there's also some, some medical reasons, right? So if you wait a certain amount of time, like you don't get the same bone 

Dr. Mariza Snyder: Oh yes. Benefits, for example, let's talk about. Yeah. Yeah. So we know that in the perimenopause transition, not menopause, not early menopause, that in the perimenopause transition we are gonna see lipids often go out of range, right?

So we're gonna see more HDL climb, we're gonna see, um, HDL is gonna drop your, [00:42:00] your LDL is gonna climb. We're gonna, we're just gonna see lipids go in an unfavorable direction. And this has to do with the decline in estradiol, but also again, lifestyle and what's going on with your insulin sensitivity. So we know that's happening.

So we know that women's cardiometabolic risk is going to increase over the perimenopause transition for a majority of women. We also know that women are gonna lose bone up to 20% by the time they hit early menopause. They were losing that bone in perimenopause. Right. 

Dr. Scott Sherr: We 

Dr. Mariza Snyder: also know that women are gonna be losing more muscle as they head into early menopause as well.

Again, this doesn't wait until you haven't had a period for 12 months, right? This is happening before that. And so when I look at the most important markers for longevity and for women feeling alive in their bodies, those shifts are not happening after the 12 month mark of menopause. They're happening well before the menopause.

Like defining menopause moment, they're happening in perimenopause, and so if these hormones are most importantly, protect, protective [00:43:00] and preventative. This, then why wouldn't we be offering them earlier? So, uh, from my, in the research that I'm looking at, and unfortunately it's very limited research for women in Perry.

Mm-hmm. But in what I've seen in terms of the scope of clinical research, starting women as early as we can when symptoms are present and we begin to see some shifts in, in labs and we, not just the hormone labs I'm talking about in highly sensitive CRP I'm talking about in. Fasting insulin, fasting glucose.

Got it. These are all the full lip lipid panel. If I am seeing that shift as well, the silent shift on your DEXA scan, if I'm already starting to see a decline in lean mass and an increase in, you know, in, in, in fat mass, all of these things really indicate that there are hormones that are declining erratically and to bring in hormone support, especially if symptoms indicate.

Dr. Scott Sherr: Okay. I think that's just important. I like to, I like to echo, echo that it's not just about waiting for symptoms to develop. There's all these other things that are happening, sort of underlying physiology [00:44:00] that would really benefit from getting on those hormones faster, uh, than, you know, than most women are doing at this point.

Yeah. Um, yeah. 

Dr. Mariza Snyder: Women don't need to suffer needlessly. Yeah. I don't, I don't know why that became the narrative that we just kind of need to suffer through this. You know, I had a a, a fellow doctor of mine, actually, I'll just share 'cause I'm, I'm doing a whole series on what happened to you in perimenopause.

Mm. The experts. Sure. And a, a fellow, um, Dr. Dr. Aviva Ramm. Okay. Um, towards the end of late, late perimenopause was struggling with insomnia, struggling with cognitive issues, and she went to her PCP, um, because, you know, we should probably not diagnose ourselves and you know Sure. Like, doctors 

Dr. Scott Sherr: should go see doctors.

I, doctor, I agree. I agree. Totally. Totally. I have a lot of 

Dr. Mariza Snyder: doctors who, who I get to, who get to help take care of me. Sure. Right. And I'm always looking at my own stuff. Like, I'm like, okay, lemme see if this is right for me. And then I'm my own Guinea pig. Of course, you know, I'm like, is this amount of testosterone and progesterone, is this the right dosage?

You know, it's not just the labs, but it's like, how do I feel? So she goes, and it happens. [00:45:00] She has a sub, her PCP is on vacation and she gets a different doctor, and this woman's in her sixties and she's like, listen, I'm struggling with sleep. I'm struggling with all these symptoms. I, I would really love to start.

Progesterone and looking into an estradiol patch and this woman straight up was like, one, it is not indicated for you. It's not indicated for these symptoms. And you know what? You just need to deal with it. Period. 

Dr. Scott Sherr: Yeah. 

Dr. Mariza Snyder: Hard stop. Yeah. Like I deal with it like this. These are the things I do to deal with it.

So like, good luck. Just deal with it. And that was it. And, and she was like, I was like, how did it feel to be the patient that all that, that, to be in that that particular position that so many women have come to you because of. Like 

Dr. Scott Sherr: it's, 

Dr. Mariza Snyder: it's something to be in that lived experience of co totally being gaslit, totally being told no, saying that it's not appropriate when it's a hundred percent appropriate, and, and then having to like go back and massively advocate for yourself.

And it was, it was really fun to have that conversation and for her to. Have that [00:46:00] experience to know what it feels like to be told, Nope, we can't help you. And two, suck it up. 

Dr. Scott Sherr: Yeah. Amazing. And such a, a challenge I know for so many women out there, but, but this has been great. Um, Marita, so I want to ask you some questions before we finish.

Yeah. 'cause I know, you know, we're cutting up to the end of the hour and you gotta roll. And I have some fun ones for you. Okay. If you're ready. You all good? You ready? 

Dr. Mariza Snyder: I'm ready. I'm ready. I'm ready. 

Dr. Scott Sherr: So like the name of the podcast, smarter or Not Harder, our Lives Trying to Live Smarter or Not Harder as much as we can.

What are the three things that you may have already even just mentioned them? If you have three things you could give advice to anybody listening across all of your levels of knowledge, experience, what would those three things be? Mariza 

Dr. Mariza Snyder: number one would be to build your life around movement. Hard stop, like love it.

Build your life around movement. We do not move enough. We, we need to be physically active, like, move your butt. Exercise snacks. I don't care. Just get in where you fit in. Number two is gonna, is really gonna be sleep consistency. We know that sleep consistency is one of the biggest [00:47:00] levers that you can pull for your health span.

So treat your sleep like it's a million dollar meeting. Number three, spend time with the people that you love. Doing the things that you love. That's probably the biggest predictor of your health span and your, your, your quality of life is being with the people that you love in real time and just really honoring that community is everything as we step into the second half of our lives.

Dr. Scott Sherr: I love that. And the whole blue zone. Blue zone, excuse me, the fiasco, fiasco things are all really about that last one, right? They were smoking, they were drinking, you know, they were all, they were all eating meat or eating vegetables. It didn't matter. But they all had communities. They all had love and support.

And so I love that you said that. And from a sleep perspective, one of the things we say at our company, uh, Dr. Ted, who's our founder, likes to say, your day doesn't start when you wake up. It starts when you go to bed. And so that should be the first thing you do every day, not the last thing. And if you treat it like that with a priority like that.

The first thing you check off your list, not the last. So I love it. Um, Mari so [00:48:00] tell people where they can learn more about you, your book, your work, your podcast. Give us, give it to all of us. Give it to us. 

Dr. Mariza Snyder: Absolutely. Well, I have a new book coming out called The Perimenopause Revolution. And so much about what we talked about today is in this book and more like lab reference ranges.

What should we be looking at? How do these hormones profoundly impact every system of the body, including the brain, right? And then the principles. Sleep circ, sleep consistency, circadian rhythm optimization, blood glucose, um, optimization. Really looking at the massive pillars that are gonna improve our health span as we move into the second half of our life, including mindset.

Such a big piece of that, like who are you becoming in the second half of your life? When you get crystal clear on that, like. It all just falls into place. So I love, that's another big piece of, you know, working smarter, not harder is having purpose. Yeah. And knowing who your future self is going to be. Um, the podcast is called Energized with Dr.

Marisa. I just had you on there. It was such a fun conversation. We talked a lot about. Sleep. Sleep and gaba and just really got into the nitty [00:49:00] gritty about how we can have more energy. Um, and then on Insta at Dr. Marisa, so D-R-M-A-R-I-Z. A lot of humor, a lot of, um, levity around perimenopause, but also a lot of recommendations.

Dr. Scott Sherr: I love it. Well, this has been a fantastic conversation. I really appreciate you all your work. Have a great weekend. Solo pr solo at home relaxing. Yes. Solo weekend. Projective 

Dr. Mariza Snyder: weekend. Yes. Yeah, I haven't broken that habit. Let me tell you. 

Dr. Scott Sherr: No need. No need. Well, everybody, thanks so much for listening and we'll check you next time.

Take care.

Find more from Dr. Mariza Snyder:

Website: https://www.drmariza.com

Instagram: https://www.instagram.com/drmariza

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